tailieunhanh - ABC OF INTERVENTIONAL CARDIOLOGY – PART 5

Các biến chứng tim khối là một biến chứng cấp tính thường xuyên, do đó, một điện cực đặt máy tạo nhịp tạm thời được chèn vào thông qua tĩnh mạch đùi trước và thường để lại tại chỗ trong vòng 24 giờ sau khi thủ tục, trong thời gian bệnh nhân được theo dõi. | Non-coronary percutaneous intervention Complications Heart block is a frequent acute complication so a temporary pacing electrode is inserted via the femoral vein beforehand and is usually left in situ for 24 hours after the procedure during which time the patient is monitored. The main procedural complications are persistent heart block requiring a permanent pacemaker 10 coronary artery dissection and infarction requiring immediate coronary artery bypass grafting 2 and death 1-2 . The procedural mortality and morbidity is similar to that for surgical myectomy as is the reduction in left ventricular outflow tract gradient. Surgery and ethanol septal ablation have not as yet been directly compared in randomised studies. Micrograph of hypertrophied myocytes in haphazard alignments characteristic of hypertrophic cardiomyopathy. Interstitial collagen is also increased Simultaneous aortic and left ventricular pressure waves before left and after right successful ethanol septal ablation. Note the difference between left ventricular peak pressure and aortic peak pressure which represents the left ventricular outflow tract gradient has been reduced from 80 mm Hg to 9 mm Hg Septal defect closure Atrial septal defects Atrial septal defects are congenital abnormalities characterised by a structural deficiency of the atrial septum and account for about 10 of all congenital cardiac disease. The commonest atrial septal defects affect the ostium secundum in the fossa ovalis and most are suitable for transcatheter closure. Although atrial septal defects may be closed in childhood they are the commonest form of congenital heart disease to become apparent in adulthood. Diagnosis is usually confirmed by echocardiography allowing visualisation of the anatomy of the defect and Doppler estimation of the shunt size. The physiological importance of the defect depends on the duration and size of the shunt as well as the response of the pulmonary vascular bed. Patients with significant .